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This is VAERS ID 263314

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263314
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-08-28
Onset:2006-08-29
Submitted:2006-09-19
Entered:2006-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR, INC. C2557AA / 0 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic rhinitis, RAD
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:On 8/29/06 pt woke up in am to rash on face and fever of 103. Rash not itchy. Treatment Tylenol or Motrin for fever. On 8/30/06 Pt continues with rash on face off and on and also fever continues. Temperature ranging 99.2 - . Also complains of headache.


Changed on 12/8/2009

263314 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-08-28
Onset:2006-08-29
Submitted:2006-09-19
Entered:2006-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR C2557AA / 0 RA / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Headache, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic rhinitis, RAD
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:On 8/29/06 pt woke up in am to rash on face and fever of 103. Rash not itchy. Treatment Tylenol or Motrin for fever. On 8/30/06 Pt continues with rash on face off and on and also fever continues. Temperature ranging 99.2 - . Also complains of headache.


Changed on 5/14/2017

263314 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-08-28
Onset:2006-08-29
Submitted:2006-09-19
Entered:2006-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2557AA / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Headache, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic rhinitis, RAD
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:On 8/29/06 pt woke up in am to rash on face and fever of 103. Rash not itchy. Treatment Tylenol or Motrin for fever. On 8/30/06 Pt continues with rash on face off and on and also fever continues. Temperature ranging 99.2 - . Also complains of headache.


Changed on 9/14/2017

263314 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-08-28
Onset:2006-08-29
Submitted:2006-09-19
Entered:2006-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 LA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2557AA / 0 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Headache, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic rhinitis, RAD
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:On 8/29/06 pt woke up in am to rash on face and fever of 103. Rash not itchy. Treatment Tylenol or Motrin for fever. On 8/30/06 Pt continues with rash on face off and on and also fever continues. Temperature ranging 99.2 - . Also complains of headache.


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